Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Eur J Pediatr. 2024 Sep;183(9):4123-4131. doi: 10.1007/s00431-024-05665-6. Epub 2024 Jul 10.
Congenital hypothyroidism (CH) is detected through a newborn screening program in Iran, enabling early detection and prompt treatment. This study addresses the longitudinal growth trajectory of Iranian children with CH and explores associated factors during the first 3 years of life. Data from 1474 children with CH in Isfahan, Iran (2002-2022), were analyzed. Weight, height, and head circumference were measured, and z-scores for age were calculated. Group-based trajectory modeling was applied to distinct growth trajectories. Factors influencing growth patterns, including gender, treatment initiation age, delivery method, parental consanguinity, history of familial hypothyroidism, and thyroid-stimulating hormone (TSH) levels at 3-7 days, were investigated. Thirty-seven percent of children diagnosed with CH faced a delay in weight, while 36.6% experienced stunted height, and 25.7% showed a retardation in head circumference growth. The initiation of treatment, parental consanguinity, and family history of hypothyroidism varied among these groups. Children exhibiting an optimal growth pattern in the initial 3 years of life demonstrated lower average TSH levels.
This research emphasizes the complexity of managing CH and stresses the importance of tailoring interventions based on individualized characteristics and the ongoing growth patterns of the children. Future research is required to understand the intricate relationships between growth patterns and various determinants and optimize the growth and developmental outcomes of children with CH.
• Iran has a higher prevalence of congenital hypothyroidism (CH) with a nationwide screening program. • There are concerns about delayed growth in CH children, but limited research on long-term patterns and contributing factors.
• Distinct patterns in weight, height, and head circumference among children with CH were identified. • Factors such as consanguinity, parental hypothyroidism, and TSH levels impact growth outcomes. • CH management is complicated, and there is a need for individualized interventions.
通过伊朗的新生儿筛查计划发现先天性甲状腺功能减退症(CH),从而实现早期发现和及时治疗。本研究旨在探讨伊朗 CH 患儿的纵向生长轨迹,并分析其生命最初 3 年的相关影响因素。
分析了伊朗伊斯法罕的 1474 例 CH 患儿(2002-2022 年)的数据。测量了体重、身高和头围,并计算了年龄的 z 评分。采用基于群组的轨迹建模方法分析了不同的生长轨迹。探讨了影响生长模式的因素,包括性别、开始治疗的年龄、分娩方式、父母近亲结婚、家族性甲状腺功能减退症病史以及 3-7 天的促甲状腺激素(TSH)水平。
37%的 CH 患儿体重增长延迟,36.6%的患儿身高增长受限,25.7%的患儿头围增长迟缓。这些患儿在开始治疗、父母近亲结婚和家族性甲状腺功能减退症病史方面存在差异。在生命最初 3 年中表现出最佳生长模式的儿童其平均 TSH 水平较低。
本研究强调了管理 CH 的复杂性,并强调了根据个体特征和儿童持续的生长模式定制干预措施的重要性。需要进一步研究以了解生长模式与各种决定因素之间的复杂关系,并优化 CH 患儿的生长和发育结局。
• 伊朗开展了全国性的筛查计划,其先天性甲状腺功能减退症(CH)的患病率较高。• 人们对 CH 患儿生长迟缓的情况表示担忧,但关于其长期模式和相关因素的研究有限。
• 确定了 CH 患儿体重、身高和头围的不同模式。• 近亲结婚、父母甲状腺功能减退症和 TSH 水平等因素会影响生长结果。• CH 管理较为复杂,需要个体化干预。